- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,183.50 / $24,077.50 / $33,308.50
| Facility | | $7,183.50 | $24,077.50 | $33,308.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,133.36
| Facility | | $1,146.00 | $3,000.00 | $7,133.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,062.45 / $12,521.56 / $23,225.69
| Facility | | $9,062.45 | $12,521.56 | $23,225.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,062.45 / $12,930.30 / $23,225.69
| Facility | | $9,062.45 | $12,930.30 | $23,225.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,072.68 / $24,849.16
| Facility | | $5,419.00 | $18,072.68 | $24,849.16 |